经皮肝穿刺胆道造影CT检查诊断胆道梗阻性疾病

摘要

Preoperative diagnosis of biliary obstruction mainly depends on imaging examination.Percutaneous transhepatic cholangiography (PTC) is a common method in detecting biliary obstruction.PTC combined with computed tomography (CT) could enhance the diagnostic rate.From April 2009 to April 2011,8 patients with biliary obstruction were admitted to the Shenzhen Hospital of Peking University.Contrast solution (30 ml of iodine solution at a concentration of 1.5％ -2.0％)was injected through a PTC tube,and then CT scan was performed.An iohexol contrast solution at a concentration of 300 mgl/ml was injected at a dosage of 1.5 ml/kg and at 3-5 ml/s,then the arterial phase,venous phase and delayed phase were scanned.The original data were uploaded to Vitrea 2 workstation for multiplane reconstruction,maximum intensity projection and volume rendering.The procedure was successfully performed on all patients,and the position of the biliary obstruction was identified in 7 patients.Five patients were diagnosed as with hilar cholangiocarcinoma,1 with sclerosing cholangitis and 2 with adenoma of the distal common bile duct.The patients' symptoms were alleviated after percutaneous transhepatic biliary drainage.%胆道梗阻性疾病的术前诊断主要依赖于影像学检查,且检查结果直接关系到临床疗效及患者预后.PTC是胆道梗阻性病变最常用的检查方法.在PTC基础上进行CT检查可提高胆道梗阻性病变的检出率[1].近年来多层螺旋CT的广泛应用,尤其是图像后处理技术和软件的开发,为PTC+CT检查创造了条件.2009年4月至201 1年4月我院采用PTC+CT检查诊断胆道梗阻性疾病8例,取得了较满意的效果.